Risk factors of fecal carriage with extended-spectrum β-lactamase-producing Enterobacteriaceae in hospitalized patients

Background: Colonization of multidrug-resistant microorganisms is a potential source of cross transmission and subsequent infection. Screening of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) is not yet a routine practice in most hospitals. Methods: The purpose of this study was to investigate the risk factors of fecal carriage of ESBL-E in hospitalized patients. A total of 174 samples (from 97 patients) was collected. Screening test was accomplished using commercial chromogenic medium (ChromID ESBL agar; bioMerieux, Marcy l'Etoile, France). The presence of ESBLs of grown isolates was confirmed by Clinical and Laboratory Standards Institute guidelines. Analysis of the risk factors of ESBL-E carriage was performed by multivariate logistic regression. Results: Among the risk factors, multivariate analysis demonstrated that prolonged hospitalization (>= 90 days) (odds ratio [OR], 6.76; 95% confidence interval [CI]: 1.17-39.23; P=.033), prolonged intensive care unit stay (>= 14 days) (OR, 4.78; 95% CI: 1.70-13.42; P=.003), and methicillin-resistant Staphylococcus aureus carriage (OR, 3.29; 95% CI: 1.20-9.01; P=.020) were found to be significantly associated with fecal carriers. Conclusion: This study clarified the characteristics and the risk factors of hospitalized patients carrying ESBL-E. In addition, the cost-benefit of routine screening in addition to methicillin-resistant Staphylococcus aureus and vancomycin-resitant Enterococci needs to be assessed. Copyright (C) 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.